Mutaf Mehmet, Günal Ertan, Berberoğlu Ömer, Gökçe Ayla
From the Department of Plastic and Reconstructive Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey.
Ann Plast Surg. 2014 Nov;73(5):583-7. doi: 10.1097/SAP.0b013e3182840831.
Recurrence of the sacrococcygeal hidradenitis suppurativa (HS) can significantly be reduced by invasive local excision of all the abscess, sinuses, and scars which often result in large defects on this region. Although a number of surgical procedures have been described, closure of large sacrococcygeal defects resulting from excision of extensive HS still remains a challenge.
Here, we present the use of triangular closure technique as a new alternative in surgical treatment of extensive HS of sacrococcygeal region.
For more than 4 years, triangular closure technique has been used for skin coverage of the large sacrococcygeal defects resulting from excision of the HS in 16 patients (12 men and 4 women) aged between 18 and 52. The size of the defects range from 10 to 25 cm in the greatest dimension.
In all patients, a successful tension-free closure of the defect was obtained. Except for 2 patients who had tip necrosis, all patients healed uneventfully. There was no patient with infection and wound dehiscence. A mean follow-up for 36 months (6 months-5 years) revealed no recurrence and an aesthetically acceptable scar formation in all patients. No patient required additional surgery.
Triangular closure technique enables the surgeon to achieve a tension-free defect closure of remarkably large sacrococcygeal defects resulting from surgical excision of extensive HS. Using 2 well-vascularized fasciocutaneous flaps, it provides a durable coverage and soft tissue padding over sacrococcygeal and gluteal region with good cosmesis. With these advantages, triangular closure technique seems to be a useful, 1-stage, and safe reconstructive alternative for the closure of these challenging defects.
通过对所有脓肿、窦道和瘢痕进行侵入性局部切除，可显著降低化脓性藏毛窦（HS）的复发率，但这通常会导致该区域出现大的缺损。尽管已描述了多种手术方法，但因广泛切除HS导致的巨大骶尾部缺损的闭合仍然是一项挑战。
在此，我们介绍三角闭合技术作为骶尾部广泛HS手术治疗的一种新选择。
4年多来，三角闭合技术已用于16例年龄在18至52岁之间（12例男性和4例女性）因切除HS导致的巨大骶尾部缺损的皮肤覆盖。缺损最大尺寸范围为10至25厘米。
所有患者均成功实现了缺损的无张力闭合。除2例出现尖端坏死外，所有患者均顺利愈合。无患者发生感染和伤口裂开。平均随访36个月（6个月至5年）显示所有患者均无复发，且形成的瘢痕在美学上可接受。无需患者进行额外手术。
三角闭合技术使外科医生能够对因广泛切除HS导致的巨大骶尾部缺损实现无张力闭合。使用2个血运良好的筋膜皮瓣，它可在骶尾部和臀区提供持久的覆盖和软组织填充，且美容效果良好。具有这些优点，三角闭合技术似乎是闭合这些具有挑战性缺损的一种有用的、一期且安全的重建选择。
